Understanding the Syndrome, Complications, and Nursing Considerations
Introduction
Mild muscle pain can be a common side effect of physical means, such as intense workouts, over usage of muscle, and/or blocked blood vessels, or by chemical means, such as toxins, heat or drugs. Oftentimes, people who experience muscle aches can easily pinpoint the cause due to their knowledge of the stress, tension, or physical activity they have endured. Rhabdomyolysis, or dissolution of skeletal muscle, is a syndrome caused by injury to skeletal muscle and involves the leakage of large quantities of potentially toxic intracellular contents into plasma (Muscal, 2013). In contrast to mild muscle pain, Rhabdomyolysis, commonly known as ‘Rhabdo’, may result in life-threatening renal failure and disseminated intravascular coagulation (DIC) while also being multifactorial in adult patients (Muscal, 2013). Approximately 28-37% of all Rhabdomyolysis cases in the United States require short term hemodyalysis (Melli G, 2013). The purpose of this paper is to explore the causes, signs and symptoms, nursing considerations and workout trends that are being blamed for inducing ‘Rhabdo’ in athletes.
Rhabdomyolysis
According to the National Discharge Survey, there are approximately 26,000 cases of Rhabdomyolysis that are reported throughout the United States annually (Melli G, 2013). Sixty percent of these cases in adults include multiple factors such as trauma and compression leading to direct muscle injury, occlusion of vessels from thromboemboli or surgical clamping, prolonged immobilization, burns and fractures. However, Rhabdomyolysis in pediatric patients is often caused from infections, trauma, metabolic conditions and muscle diseases. (Mannix R,...
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...ry and rhabdomyolysis. Crit Care Clin. Jan 2004;20(1):171-92.
Mannix R, Tan ML, Wright R, Baskin M. Acute pediatric rhabdomyolysis: causes and rates of renal failure. Pediatrics. Nov 2006;118(5):2119-25
Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis: an evaluation of 475 hospitalized patients. Medicine (Baltimore). Nov 2005;84(6):377-85.
Muscal, E. (2013, September 16). Rhabdomyolysis . Retrieved from Medscape: http://emedicine.medscape.com/article/1007814-overview.
Ray, M. (2010, January ). The Truth About Rhabdomyolysis . Retrieved from The CrossFit Journal : http://journal.crossfit.com/2010/01/rhabdo-pdf.tpl#featureArticleTitle
Sauret, J. M. (2002, March 1). Rhabdomyolysis . Retrieved from American Family Physician : http://www.aafp.org/afp/2002/0301/p907.html
Vanholder R, Sever MS, Erek E, Lameire N. Rhabdomyolysis. J Am Soc Nephrol. Aug 2000;11(8):1553-61.
Rhabdomyolysis is a disease that involves a rupture of skeletal muscle, causing myoglobin, along with electrolytes and other intracellular proteins to leak in to circular system (Bagley et al, 2007). It is the result from the destruction of muscle fibers that make their way into the bloodstream, which take over the renal system hindering the kidneys ability to remove waste resulting in kidney failure (Owens, 2013). Rhabdomyolysis is rare and has not been fully documented. According to Efstratiadis et al, rhabdomyolysis was solely associated with crush injuries, but in recent studies, it appears to be five times more frequent in non-traumatic causes (2007). Damaging electrolyte disorders and acute renal failure may occur, leading to life-threatening situations. Some of the most common signs and symptoms of patients with rhabdomyolysis are colored urine, and muscle weakness is and Delayed Onset Muscle Soreness (DOMS). Rhabdomyolysis may develop in any circumstances where energy demands in muscles exceed the available energy supplies of the body. According to
Controlled increases in physical stress through progressive resistive exercise cause muscle fibers to hypertrophy and become capable of generating greater force.3 Early emphasis is on restoring joint range of motion and muscle flexibility, however, resistive exercises are not delayed. The initial emphasis of muscle loading should be on endurance, accomplished with lower loads and higher repetitions. Progressive resistive exercises are initiated at the available range and progressed to new positions as wrist range of motion returns in all planes. Both the overload principle and the SAID Principle (Specific Adaptation to Imposed Demands) are important considerations in therapeutic exercise dosing.1,3,11 Within pain tolerance, dosing progressive resistive exercises that maintain a therapeutic stress level will encourage muscle tissue hypertrophy. Finding activities that produce the correct force and repetition, without injury, is the goal of the remobilization period. Starting with low force, moderate to high repetitions, and encouraging therapeutic rest following induced stress is important to both the overload principle and the SAID Principle. Additionally, it is important to prevent dosing resistive exercises that exceed optimal stress, which may result in injury. The patient’s response to therapeutic exercise should be assessed during, immediately following,
... metabolism after depletion of muscle glycogen. Medicine & Science in Sports & Exercise, 25 (6): 733-40.
Kuhn, C., Swartzwelder, S., and Wilson, W. Pumped: Straight Facts for Athletes about Drugs, Supplements, and Training. 2000. W.W. Norton, New York and London.
(5) NIH Publication No. 03–4241. Your Kidneys and How They Work. National Kidney and Urologic Diseases Information Clearinghouse, 2003. http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/
Tamparo, C. D. & Lewis, M. A. (2011). Diseases of the human body. Philadelphia, PA: F.A. Davis Company.
The renal disease are common nowadays .The acute renal failure is a medical term means that the kidneys stopped from working and not able to clear toxins from body ,not able to maintained a stable electrolyte balance inside the body and not able to secret the extra fluid as urine outside the body. The renal replacement therapy (RRT) or dialysis has been discovered on 1913 by Able, Rowntree and Turner in London, UK.
Litsky, F. (1998, May 2). PLUS: COLLEGE WRESTLING; Creatine Ruled Out In Athletes' Deaths. The New York Times , pp. 1-1.
Describe the pathology/condition from a reputable source. Include its etiology (how, when and why it occurs)
Indication: “Edema due to liver cirrhosis or nephrotic syndrome. Edema in patients with hypokalemia due to other diuretics.”
The patient is a 56-year-old gentleman who presented to the ED with a complaint of constipation for 5 days prior to presentation patient reports child the being bags of sunflower seeds 6 days prior to presentation and since that time he has not had a bowel movement. He reports some associated left lower quadrant pain 2/10, sharp and constant. He also reports associated increased urinary frequency and straining to urinate. He has no significant past medical history. He has tried some stool softeners etc. at home with no results. Clinical review of his records indicates he does have a mild elevation in his white count with a left shift. His SMA-18 reveals some hypokalemia. Urinalysis reveals a small amount of blood. A CT the abdomen
United States Renal Data System (USRDS). (2008). Annual data report: Incidence and prevalence. Retrieved July 8, 2009, from http://www.usrds.org/2008/pdf/V2-02-2008.pdf
From the results of the numerous tests carried out according to the patient history of frothy urine with a significant oedema over a maximum period of 5 days, the patient was diagnosed with Nephrotic Syndrome. This is condition that occurs due to leakage in the kidney filtration part leading to a large amount of protein leaking from the blood into the urine. This is mainly due to fluid retention known as oedema which is as a result of low protein level in the blood. It occurs due to abnormal functioning or a part of the kidney is affected (glomeruli). This syndrome can be caused by numerous diseases coming together to cause or form one particular disease; these causes range from minimal change disease, membranous nephropathy, focal segmental glomerulosclerosis (FSGS) and other conditions, disorders of the glomeruli. The membranous nephropathy also known as the membranous nephritis or membranous glomerulonephritis, only causes diseases in adults and very uncommon in children. Leakage occurs from this due to the thickening of the membranous in the glomeruli which is the filter of the glomeruli. Focal segmental glomerulosclerosis is a causative due to the formation of small scars (sclerosis) on some of the kidney glomeruli. Another form of cause of nephrotic is minimal change which is due to lack of virtual change detected in the glomeruli when examined under the microscope. This causes the syndrome in 9 out of a total of 10 children under the age of 5 years.
... Medicine. 3rd ed. Vol.3. Detroit: Gale, 2006.2139-2141. Gale Virtual Reference Library. Web. 3 Apr. 2014.
Melmed A., “Acromegaly pathogenesis and treatment,” Journal of Clinical Investigation, vol. 119, no. 11, pp. 3189–3202, 2009.